DOI: 10.11648/j.jfmhc.20261203.11 ISSN: 2469-8342

Factors Affecting Nurses’ Clinical Decision-Making at Adult and Paediatric Emergency and Critical Care Units in Orotta National Referral Hospital in Asmara, Eritrea, 2025

Hisabu Gebremedhin, Okbamichael Zewde, Humed Humed, Mebrahtu Redae, Samuel Abay, Sofonyas Beyene, Eyasu Tesfamariam
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Background: Clinical decision-making is essential to the advancement of professional nursing practice. Competent nurses must apply sound decision-making skills to deliver safe and effective care. The decisions made by nurses have a direct and immediate impact on patient outcomes, including survival. Objectives: This study aimed to assess the level of clinical decision-making among nurses and identify the factors influencing it within Adult and Pediatric Emergency and Critical Care Units. Methods: An analytical, quantitative cross-sectional study design was conducted from October 2024 to March 2025 at Orotta National Referral and teaching Hospital. Data were collected using an adapted, predesigned, and pre-tested questionnaire comprising demographic variables and decision-making items. Descriptive statistics, independent samples t-test, and one-way ANOVA with Tukey post-hoc test were used for analysis employing SPSS Version 26.0. Result: clinical decision-making scores ranged from a minimum of 40 to76, with a mean score of 56.58. Using the mid-point of the scores as a cut-off, 45.1% of nurses demonstrated high decision-making performance. Notably, 87% of nurses who refrained from adjusting inotropic infusions without a physician’s order reported that such actions were not permitted. Statistically significant differences in decision-making scores were observed based on sex (p<0.001), professional level (p<0.002) and position held (p<0.01). Conclusion Considerable proportion of nurses exhibited limited clinical decision-making capacity. Implication: Understanding the level and determination of nurses’ clinical decision-making is crucial for enhancing nursing practice and informing organizational policies.

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